The aim of this study was to examine the efficacy of the operative method of modified osteomyoplasty in relation to primary “guillotine” amputation in Croatian war amputees. From 1995 to 2000 a total of 425 patients underwent transtibial amputation for their war-related injuries. From these group, 52 patients were selected that were unable to tolerate prosthetic wear. Following primary amputation, these 52 patients underwent reamputation surgery using the technique of modified osteomyoplasty. The efficacy of the operative method was assessed in relation to age, presence of complications before amputation, the level of amputation, the number of amputations, motivation for social integration, and the normalization of physical activity and the patient's level of satisfaction (graded from 1, unsatisfactory to 5, completely satisfactory). The results of the analysis showed that the application of modified osteomyoplasty as the method of choice for transtibial residual limb reconstruction creates the basic prerequisite for functional prosthetic fitting. The level of satisfaction significantly increased from the mean value of 1.21 before the surgery to the mean of 2.96 one year after the surgery (Z = −6.270, p < 0.001, Wilcoxon signed rank test).